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A nurse is caring for a patient with a chest tube following a left-sided pneumothorax. During routine assessment, the nurse notes that fluctuation in the water seal chamber has stopped. The patient’s SpO₂ is 94% on room air, breath sounds are equal bilaterally, and the patient denies dyspnea. What is the nurse’s priority action?  

A 7-year-old child with a history of asthma presents to the emergency department with audible wheezing, intercostal retractions, tachypnea, and difficulty speaking in full sentences. The child appears anxious and is sitting upright, leaning forward. Which intervention should the nurse implement first?

A nurse completes discharge teaching for a patient newly prescribed montelukast for persistent asthma. Two weeks later, the patient’s spouse calls and reports the patient has become withdrawn, is sleeping poorly, and made a concerning comment about “not wanting to be here anymore.” What conclusion does the nurse draw?  

A client with moderate persistent asthma is prescribed a long-acting beta₂-adrenergic agonist (LABA) inhaler. During a follow-up appointment, which client report requires the most immediate follow-up by the nurse?  

A nurse is caring for a patient with an acute asthma exacerbation who received IV methylprednisolone 125 mg six hours ago. The patient reports feeling much better with an SpO₂ of 97% and unlabored breathing. The nurse notes a bedside blood glucose of 290 mg/dL. The patient states, “I’m not diabetic, so that machine must be wrong.” What is the nurse’s priority action?  

The nurse is developing a plan of care for a school-age child with cystic fibrosis (CF). Which intervention should the nurse include as a priority component of daily management?

A 29-year-old patient with moderate persistent asthma presents to the ED with worsening shortness of breath. The patient’s baseline peak flow is 450 L/min. Current assessment findings: Peak flow = 200 L/min, Respiratory rate = 28/min, Heart rate = 124 bpm, Oxygen saturation = 92% on room air, Auscultation: faint expiratory wheezes and prolonged expiratory phase. Which finding indicates the patient is at greatest risk for impending respiratory failure?                                         

The school nurse is assessing a first-grade child who has had upper respiratory symptoms for more than 1 week. Based on clinical findings consistent with acute sinusitis, which assessment findings would support this suspicion? (Select all that apply.)

A nurse responds to an alarm and finds that a patient’s tracheostomy tube has been accidentally dislodged. The tracheostomy was placed 2 days ago. The patient has a respiratory rate of 32 with intercostal retractions and an SpO₂ of 84%. What is the nurse’s priority action?  

The nurse is evaluating teaching provided to the parents of a 2-year-old child with cystic fibrosis (CF) regarding home respiratory therapy. Which statement by the parents indicates a correct understanding of the prescribed respiratory regimen?